Individual provider Active NPI

Kelly Nichols, APRN

  • Acute Care Nurse Practitioner
  • Paducah, KY
National Provider Identifier
1447709159
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
3010752 Issued in KY
Practice address
2601 Kentucky Ave
Suite 300
Paducah, KY 42003-3817
Phone
(270) 443-5564
Fax
(270) 443-5549
NPI assigned
Sep 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 3010752 KY Primary

Addresses

Primary practice location

2601 Kentucky Ave
Suite 300
Paducah, KY 42003-3817

Mailing address

2605 Kentucky Ave
Suite 306
Paducah, KY 42003-3800
Phone (270) 415-7653

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address knichols47933@bhkydirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161025002462 KY Practitioner - Nurse Practitioner 1658659719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

2601 Kentucky Ave
Suite 300
Paducah, KY 42003-3826
Phone (270) 443-5564

Hospital & facility affiliations

  • Baptist Health Paducah Hospital, Paducah, KY, CCN 180104

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3010752KYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Oct 17, 2016 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Oct 17, 2016 Accepting new patients

Locations

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

2605 Kentucky Ave
Ste 306
Paducah, KY 42003
Phone (270) 415-7653

2601 Kentucky Ave
Ste 300
Paducah, KY 42003
Phone (270) 443-5564

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1447709159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 KENTUCKY AVE",
            "address_2": "SUITE 306",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033800",
            "telephone_number": "270-415-7653",
            "fax_number": "270-575-8359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 KENTUCKY AVE",
            "address_2": "SUITE 300",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033817",
            "telephone_number": "270-443-5564",
            "fax_number": "270-443-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "KELLY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-23",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "3010752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knichols47933@bhkydirect.com",
            "affiliation": "N",
            "address_1": "2601 Kentucky Ave",
            "address_2": "Suite 300",
            "city": "Paducah",
            "state": "KY",
            "country_code": "US",
            "postal_code": "420033817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.